Is There Still a Place for Cast Wedging in Pediatric Forearm Fractures?

Abstract

Level IV.

Cast wedging: A systematic review of the present evidence

“…Overall, three studies meeting the inclusion criteria mentioned above were identified during the systematic literature search. 16 - 18 Table 1 gives an overview of the studies’ characteristics. In total, 316 patients were included (Keenan and Clegg: 17 six patients, Samora et al: 18 61 patients, Kattan et al: 16 249 patients).…”

“… 16 - 18 Table 1 gives an overview of the studies’ characteristics. In total, 316 patients were included (Keenan and Clegg: 17 six patients, Samora et al: 18 61 patients, Kattan et al: 16 249 patients). The study design was prospective in the study by Samora et al, 18 retrospective in the study by Kattan et al 16 and Keenan and Clegg 17 did not provide the study design.…”

“…The included patients’ ages were in the range of 7.1 years to 9.3 years on average. Keenan and Clegg 17 analysed four forearm and two lower leg fractures, whereas Samora et al 18 primarily included 48 both-bone forearm fractures and 22 distal radius fractures. Of these, nine patients had to be excluded due to missing radiographic data.…”

“…Indication for cast wedging was given by Samora et al 18 to be > 20° angulation in distal radius fractures at any plane, > 15° angulation in forearm middle third fractures at any plane or > 10° angulation in forearm proximal third fractures at any plane. Kattan et al 16 used > 5° angulation at tibial side and > 10° angulation at forearm fractures as indication for cast wedging.…”

“…Patients were followed up for 18 weeks according to Kattan et al 16 and 11.5 weeks according to Samora et al 18 on average.…”